UCLA

Objective: This systematic review aims to explore the impact of diseases of pulpal origin (DoPO) and subsequent non-surgical root canal treatment (NSRCT) on life impact and health-related quality of life (HRQoL). The focus is on understanding the multidimensional aspects of health-related quality of life (HRQoL) and satisfaction encompassing physical, psychological, and social dimensions of overall well-being.Specific Aims: (1) To measure the impact of DoPO on OHRQoL, satisfaction, and life quality. (2) To identify the key domains by which DoPO has life-impact. (3) To measure the impact of NSRCT on OHRQoL, satisfaction, and life quality over time. Methods: Inclusion criteria encompassed various study designs (comparative or non-comparative, cross-sectional, prospective or retrospective), focusing on quantitative or qualitative data related to quality of life or satisfaction related to DoPO and NSRC) between January 1, 1990, and June 6, 2022. Publications were required to be in English, indexed in refereed literature, and include data on 10 or more individuals with DoPO, needing NSRCT, or receiving NSRCT. Studies needed clear measures, sample size descriptions, treatments provided, follow-up durations. Authors were contacted for clarification or additional data if needed. An electronic search was conducted in PubMed . Complemented by manual searches through citation mining, guidance from a reference librarian, and expert advice. Full-text articles meeting inclusion criteria were analyzed for study quality using the Wong Scale–Revised. Data abstraction facilitated quantitative and qualitative synthesis, meta-analysis where possible, and L’Abbe plotting, with normalization of data to percentages. Results: 243 titles were found through electronic searches, leading to 28 papers covering 60 populations. Most studies were recent (12 in the last 5 years, 20 in the last 10 years), from 18 countries, with acceptable to high quality ratings. Studies varied in methodologies, sample sizes (25 to 1323 individuals); comparisons made; techniques, providers, and age groups studied. OHIP scales were prevalent, but other measures such as other scales and qualitative approaches. Satisfaction was assessed in 10 studies across 18 populations using the Dugas Semantic Differential Scale (DSDS) or specific questions. Disease of pulpal origin was generally of low-to-moderate life impact when measured by OHIP-14 and -7 instruments, but other instruments tended to indicate a higher life impact. Disease of pulpal origin overwhelmingly impacted the domains of physical pain, psychological discomfort, and psychological disability, whereas the domains of functional limitation, physical disability, and social disability were considerably less impacted. Non-surgical root canal treatment provided substantial improvement in life quality when measured by change in oral health-related instruments, such as the OHIP, when measured using the Dugas Semantic Differential Scale, by simple satisfaction questions, and by qualitative methods. Most of the positive impact of NSRCT was discerned in days or weeks following treatment, and the impact was sustained through all time periods measured, up to 2 years. DoPO had a substantial negative impact on OHQoL. Whereas, NSRCT consistently showed a positive impact on HRQoL, notably reducing pain, psychological discomfort, and disability, with improvements often seen shortly after treatment and sustained throughout the study durations. Discussion: It is recommended that future studies use standard instruments, present all the domain and sub-domain data, and use multiple approaches, including the qualitative exploration of patient experience. This investigation underscores the need for standardized measurement tools in assessing the impact of non-surgical root canal treatments. It emphasizes the substantial improvements observed in patients' quality of life post-treatment, thereby advocating for comprehensive assessments in future research endeavors to better understand and enhance oral health outcomes. Conclusions: DoPO had a substantial negative impact on OHQoL, where the domains of physical pain, psychological discomfort, and psychological disability were dominant. NSRCT consistently showed a positive impact on HRQoL, notably reducing pain, psychological discomfort, and disability, where improvements were evident shortly after treatment and sustained throughout the study durations.